医改尚未成功,路在何方?

目前我国医疗制度改革尚未取得成功,这与计划经济向市场经济转轨这历史时期及卫生工作的特殊性有关,出现问题,甚至失误,在所难免。提出(1)医改的目的是确保全国人民健康,人人享有医疗保健。(2)把卫生系统推向市场,医疗机构商业化,不是医改的方向。(3)预防为主,健全预防医学制系。(4)国家增加投入。(5)制定公立及私立医院各项制度,保护医务人员的合法权益。(6)加强社区基层医疗机构的建设。     

自律:在医患关系中的定位

医疗行为的特殊性，决定了医患双方在医学信息方面的不对称性和医者拥有一定的自由裁量权，因此，医者作为医疗服务的主体，如何增强自律意识，直接关系到诚信的树立及和谐的互动式医患关系的建立和发展。     

整体护理改善护患关系的体会

整体护理的实施,重塑了护士的职业价值观,增加了护患之间的接触。护士能够在自己的专业范围内积极主动地解决病人的问题,挖掘了护理人员的自身潜力,加深了护患交流,使护患关系明显改善。     

Pediatric lupus versus adult lupus role of the laboratory

Systemic lupus erythematosus (SLE) is the archetypical immunologic disease. Approximately 20% of patients present in the first two decades of life. This article highlights some of the differences between pediatric and adult onset lupus.Children are defined as different from adults on the basis of age. Lupus presents with different gender ratios based on hormonal or pubertal status with more significant skewing toward female patients in the childbearing years. Female patients in the childbearing years appear to have a higher relative risk for mortality. Despite this, children have greater disease severity at onset based on the number of patients who present with significant organ inflammation, the amount of corticosteroids required and the abnormalities in lupus serologies including autoantibodies and low complements. Children present frequently with congenital and acquired complement defects. Children have an increased risk of infections that can be confused with lupus. They have a higher risk of serious pneumococcal infection and may have less protection from vaccinations received at the time of disease onset.The clinical immunology laboratory is critical in the diagnosis and treatment of pediatric SLE. The rapid analysis and transfer of laboratory results can be life saving for the child with suspected new onset lupus. The laboratory is also helpful in determining disease activity through analysis of immunologic trends over time in pediatric lupus patients. This is especially important in the noncompliant adolescent patient who has a correlation between disease activity and lupus serologic tests. Finally, the clinical immunology laboratory is an important tool for better understanding of the immunologic phenomena associated with lupus and of disease pathophysiology.     

县级医院经济活力及其与不同奖金制度之间的关系分析

该利用山东省县级医院普查资料，通过比较性分析方法，对奖金制度转变和医院经济活力之间的关系进行了分析。研究结果表明：在过去的20年中，医院经济活力得到了较大提高，奖金制度转变有利于医院提高经济活力。     

Children's concepts and school learning

The apparently limited classroom application of theories of learning led to an emphasis on detailed observational studies of teachers in action which produced data concerning management and teaching techniques of more obvious use to practising teachers. However, it is argued here that research into children's conceptual development is an essential complement to this initiative. Such research demonstrates the range and quality of children's concepts in areas of learning central to the school curriculum; it describes techniques for disclosing children's concepts; and it identifies the developing pattern of children's thinking which can be used to good effect in arranging appropriate and challenging learning experiences. The importance of clarity of intentions in bringing a sense of purpose and direction to the activities of learning and teaching is also emphasized.     

开展电话回访搭建医患沟通桥梁

通过对3 500余人次的有效电话回访,实施健康教育、健康指导3000余人次,受理健康咨询500余人次,协调和化解各类医疗纠纷20余起。电话回访搭起了和谐医患关系的桥梁。